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    Continuous Positive Airway Pressure (cpap) After Lung Resection: A Randomized Clinical Trial [pressão Positiva Contínua Nas Vias Aéreas (cpap) Após Ressecção Pulmonar: Ensaio Clínico Randomizado]

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    CONTEXT AND OBJECTIVE: Noninvasive mechanical ventilation during the postoperative period (PO) following lung resection can restore residual functional capacity, improve oxygenation and spare the inspiratory muscles. The objective of this study was to assess the efficacy of continuous positive airway pressure (CPAP) associated with physiotherapy, compared with physiotherapy alone after lung resection. DESIGN AND SETTING: Open randomized clinical trial conducted in the clinical hospital of Universidade Estadual de Campinas. METHOD: Sessions were held in the immediate postoperative period (POi) and on the first and second postoperative days (PO1 and PO2), and the patients were reassessed on the discharge day. CPAP was applied for two hours and the pressure adjustment was set between 7 and 8.5 cmH2O. The oxygenation index (OI), Borg scale, pain scale and presence of thoracic drains and air losses were evaluated. RESULTS: There was a significant increase in the OI in the CPAP group in the POi compared to the Chest Physiotherapy (CP) group, P = 0.024. In the CP group the OI was significantly lower on PO1 (P = 0,042), than CPAP group. The air losses were significantly greater in the CPAP group in the POi and on PO1 (P = 0.001, P = 0.028), but there was no significant difference between the groups on PO2 and PO3. There was a statistically significant difference between the groups regarding the Borg scale in the POi (P < 0.001), but there were no statistically significant differences between the groups regarding the pain score. CONCLUSION: CPAP after lung resection is safe and improves oxygenation, without increasing the air losses through the drains.13214147Lumbierres, M., Prats, E., Farrero, E., Noninvasive positive pressure ventilation prevents postoperative pulmonary complications in chronic ventilators users (2007) Respir Med., 101 (1), pp. 62-68Bellinetti, L.M., Thomson, J.C., Respiratory muscle evaluation in elective thoracotomies and laparotomies of the upper abdomen (2006) J Bras Pneumol., 32 (2), pp. 99-105Perrin, C., Jullien, V., Vénissac, N., Prophylactic use of noninvasive ventilation in patients undergoing lung resectional surgery (2007) Respir Med., 101 (7), pp. 1572-1578Benditt, J.O., Novel uses of noninvasive ventilation (2009) Respir Care, 54 (2), pp. 212-219. , discussion 219-22Battisti, A., Michotte, J.B., Tassaux, D., van Gessel, E., Jolliet, P., Non-invasive ventilation in the recovery room for postoperative respiratory failure: A feasibility study (2005) Swiss Med Wkly., 135 (23-24), pp. 339-343Auriant, I., Jallot, A., Hervé, P., Noninvasive ventilation reduces mortality in acute respiratory failure following lung resection (2001) Am J Respir Crit Care Med., 164 (7), pp. 1231-1235Aguiló, R., Togores, B., Pons, S., Noninvasive ventilatory support after lung resectional surgery (1997) Chest., 112 (1), pp. 117-121Oken, M.M., Creech, R.H., Tormey, D.C., Toxicity and response criteria of the Eastern Cooperative Oncology Group (1982) Am J Clin Oncol., 5 (6), pp. 649-655Scanlan, C.L., Myslinski, M.J., Terapia de higiene brônquica (2000) Fundamentos da terapia respiratória de Egan, pp. 817-843. , In: Scanlan CL, Wilkins RL, Stoller JK, editors. 7a ed. São Paulo: ManoleGastaldi, A.C., Magalhães, C.M.B., Baraúna, M.A., Silva, E.M.C., Souza, H.C.D., Benefits of postoperative respiratory kinesiotherapy following laparoscopic cholecystectomy (2008) Rev Bras Fisioter., 12 (2), pp. 100-106Celli, B.R., Chronic respiratory failure after lung resection: The role of pulmonary rehabilitation (2004) Thorac Surg Clin., 14 (3), pp. 417-428Silva, L.C.C., Teste de função pulmonar (2001) Condutas em pneumologia, p. 16. , In: Silva LCC, Rubin AS, Silva LMC, editores. São Paulo: RevinterJaber, S., Michelet, P., Chanques, G., Role of non-invasive ventilation (NIV) in the perioperative period (2010) Best Pract Res Clin Anaesthesiol., 24 (2), pp. 253-265Lefebvre, A., Lorut, C., Alifano, M., Noninvasive ventilation for acute respiratory failure after lung resection: An observational study (2009) Intensive Care Med., 35 (4), pp. 663-670Kindgen-Milles, D., Müller, E., Buhl, R., Nasal-continuous positive airway pressure reduces pulmonary morbidity and length of hospital stay following thoracoabdominal aortic surgery (2005) Chest., 128 (2), pp. 821-828Kallet, R.H., Diaz, J.V., The physiologic effects of noninvasive ventilation (2009) Respir Care., 54 (1), pp. 102-115Ferreira, H.C., Zin, W.A., Rocco, P.R.M., Physiopathology and clinical management of one-lung ventilation (2004) J Bras Pneumol., 30 (6), pp. 566-573Foroulis, C.N., Kotoulas, C., Konstantinou, M., Lioulias, A., Is the reduction of forced expiratory lung volumes proportional to the lung parenchyma resection, 6 months after pneumonectomy? (2002) Eur J Cardiothorac Surg., 21 (5), pp. 901-905Brunelli, A., Cassivi, S.D., Halgren, L., Risk factors for prolonged air leak after pulmonary resection (2010) Thorac Surg Clin., 20 (3), pp. 359-364Cavicchia, M.G., Soares, S.M.T.P., Dragosavac, D., Araújo, S., Ventilação mecânica em pacientes com fístula broncopleural relato de dois casos (2002) Rev Bras Ter Intensiva., 14 (2), pp. 55-58Stolz, A.J., Schützner, J., Lischke, R., Simonek, J., Pafko, P., Predictors of prolonged air leak following pulmonary lobectomy (2005) Eur J Cardiothorac Surg., 27 (2), pp. 334-336Bardell, T., Legare, J.F., Buth, K.J., Hirsch, G.M., Ali, I.S., ICU readmission after cardiac surgery (2003) Eur J Cardiothoracic Surg., 23 (3), pp. 354-359Lima, V.P., Bonfim, D., Risso, T.T., Influence of pleural drainage on postoperative pain, vital capacity and sixminute walk test after pulmonary resection (2008) J Bras Pneumol., 34 (12), pp. 1003-1007Ambrosino, N., Gabbrielli, L., Physiotherapy in the perioperative period (2010) Best Pract Res Clin Anaesthesiol., 24 (2), pp. 283-289Agostini, P., Singh, S., Incentive spirometry following thoracic surgery: What should we be doing? (2009) Physiotherapy., 95 (2), pp. 76-82Overend, T.J., Anderson, C.M., Lucy, S.D., The effect of incentive spirometry on postoperative pulmonary complications: A systematic review (2001) Chest., 120 (3), pp. 971-97
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